Chest X-Rays for Medical Students

CHRISTOPHER CLARKE, Consultant Radiologist at Nottingham University Hospitals NHS Trust, Nottingham, UK. He is a member of the British and European Societies of Gastrointestinal and Abdominal Radiology. ANTHONY DUX, Former Consultant Radiologist and Honorary Senior Lecturer at the University Hospitals of Leicester NHS Trust, Leicester, UK.

• Preface to the 2nd Edition ixAcknowledgements xiLearning objectives checklist xiiiAbout the companion website xvPart I Introduction to X-rays 11 Introduction to X-rays 3What are X-rays? 3How are X-rays produced? 3How do X-rays make an image? 4The five densities on an X-ray 4How are X-ray images (radiographs) stored? 4Hazards and precautions 52 Chest X-ray views 7PA erect chest X-ray 7Other views 83 Radiograph quality 9Inclusion 9Rotation 10Inspiration 114 Normal anatomy on a PA chest X-ray 13Right and left 13Lung zones 14The mediastinum 14Normal pulmonary vasculature 15General anatomy 16Bronchial and lobar anatomy: Figure 4.8 175 Presenting a chest radiograph 19Example of presenting a normal chest X-ray 19Part II The ABCDE of chest X-rays 216 A - Airway 23How to review the airway 23What to look for 24Tracheal deviation 24Carinal angle 257 B – Breathing 27How to review the lungs 27What to look for 28Consolidation/airspace opacification 29Air bronchogram 31Collapse (atelectasis) overview 32Pneumonectomy 41Solitary mass lesion 44Multiple mass lesions 47Cavitating lung lesion 48Fibrosis 50Pneumothorax 53Tension pneumothorax 55Hydropneumothorax 56Pleural effusion 57Pulmonary oedema 60Septal lines 64Asbestos-related lung disease 658 C – Circulation 69How to review the heart and mediastinum 69What to look for 69Dextrocardia 69Cardiomegaly (enlarged heart) 70Left atrial enlargement 71Widened mediastinum 72Hilar enlargement 76Hiatus hernia 789 D – Disability 79How to review the bones 79What to look for 80Fractures 80Sclerotic and lucent bone lesions 8110 E – Everything else (review areas) 83How to look at the review areas 83What to look for 83Gas under the diaphragm (pneumoperitoneum) 84Subcutaneous emphysema/surgical emphysema 86Mastectomy 87Medical and surgical objects (iatrogenic) 88Foreign bodies 99Part III Common conditions and their radiological signs 10111 Common conditions and their radiological signs 103Pulmonary embolism (PE) 103Primary lung malignancy 103Pneumonia 104Chronic obstructive pulmonary disease (COPD) 104Heart failure 105Tuberculosis 106Glossary 111Index 119